Individual
KENDRA TALISHA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
200 UNIVERSITY RDG, GREENVILLE, SC 29601-3635
(803) 942-3530
Mailing address
729 VALLEY GRN, MAULDIN, SC 29662-1684
(803) 942-3530
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
238074
SC
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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